Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
MBBS, MS, FMAS, FISCP, DMAS
- 8 Yrs
- ASCRS Member
Gynaecology · Emergency
Ovarian Torsion Treatment in Hyderabad: Emergency Surgery at Lux Hospitals
Ovarian torsion is the ovary twisting on the ligaments carrying its blood supply. The blood flow is cut off, and without it the ovary begins to die within hours.
This is one of the few true emergencies in gynaecology, and the ovary is usually saveable if surgery happens quickly. Our gynaecologists at Lux Hospitals, HITEC CITY assess suspected torsion urgently and operate the same day, because the timing is what determines the outcome.
- Same-Day Surgery
- Ovary Saved Where Possible
- Laparoscopic Detorsion
What is Ovarian Torsion?
Ovarian torsion occurs when the ovary rotates around the ligaments that suspend it and carry its blood vessels. Twisting first obstructs the veins draining the ovary, so it swells; the rising pressure then compromises the arterial supply, and the tissue begins to become ischaemic. The fallopian tube is usually involved alongside, which is why it is more precisely called adnexal torsion.
It almost always requires something to make the ovary heavy or unbalanced enough to rotate. A cyst of around five centimetres or larger is the usual culprit, present in the large majority of cases. Dermoid cysts are particularly implicated because their fatty contents make them buoyant and mobile. Torsion of a completely normal ovary does happen, mostly in children, but it is uncommon.
Time is what matters here more than anything else. An ovary operated on within a few hours is usually recoverable, even when it looks black and lifeless at surgery: appearance at operation is a notoriously poor guide to whether it will recover. Delay of a day or more makes salvage progressively less likely, which is why suspected torsion is investigated the same day rather than at the next available clinic.
Causes of Ovarian Torsion
Torsion needs something to make the ovary heavy or mobile enough to rotate on its pedicle.
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Ovarian cyst or mass
Present in the large majority of cases. A cyst of five centimetres or more makes the ovary heavy enough to swing on its ligaments.
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Dermoid cyst
Particularly associated with torsion. Their fatty contents make them buoyant and mobile, which is one reason dermoids are usually removed.
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Ovarian hyperstimulation
Fertility treatment enlarges the ovaries considerably, raising torsion risk substantially during stimulation cycles.
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Pregnancy
Corpus luteum cysts and the laxity of ligaments in pregnancy both increase risk, particularly in the first trimester.
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Long ovarian ligaments
Some women have naturally elongated suspensory ligaments, giving the ovary more freedom to rotate.
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Previous torsion
Having had torsion once raises the risk of it happening again, on either side.
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Sudden movement
Vigorous exercise, jumping or intercourse can trigger the rotation in an ovary already predisposed by a cyst.
This is why symptomatic and dermoid cysts are removed rather than watched indefinitely. Preventing torsion is one of the clearest arguments for treating a cyst that would otherwise be left alone.
Symptoms of Ovarian Torsion
Sudden severe one-sided pelvic pain with vomiting is the classic presentation, and it should be treated as an emergency.
Emergency symptoms
- Sudden severe pain on one side of the lower abdomen
- Pain with nausea and vomiting
- Pain that came on abruptly, often during exercise or movement
- Pain severe enough to prevent standing straight
- Fever developing after the pain
- A racing pulse or feeling faint
Variable features
- Pain that comes and goes as the ovary twists and untwists
- A dull ache over days before the severe episode
- Pain radiating to the back, flank or thigh
- A palpable tender mass in the lower abdomen
- Abnormal vaginal bleeding in some cases
- Symptoms during pregnancy or after fertility treatment
Intermittent severe pain that keeps resolving is a genuinely dangerous pattern, because it suggests the ovary is twisting and untwisting repeatedly. It should not be reassuring: it is a warning that complete torsion may follow.
How Ovarian Torsion is Diagnosed
Diagnosis is urgent and clinical. Imaging supports it but must never delay surgery where suspicion is high.
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Urgent clinical assessment
Sudden severe one-sided pain with vomiting and localised tenderness. The history alone is often enough to justify going to theatre.
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Transvaginal ultrasound with Doppler
Shows an enlarged oedematous ovary, usually with a cyst. Doppler may show reduced flow, but normal flow does not exclude torsion.
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Pregnancy test
Done immediately, since ectopic pregnancy presents identically and is itself an emergency requiring different treatment.
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Blood tests
Full blood count and inflammatory markers, mainly to assess for appendicitis and pelvic infection as alternative diagnoses.
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CT or MRI
Occasionally used where the diagnosis is genuinely unclear, though imaging should never delay theatre when suspicion is high.
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Diagnostic laparoscopy
The definitive test. Where torsion is suspected clinically, going to theatre to look is both the diagnosis and the treatment.
The most dangerous mistake here is being reassured by a normal Doppler. The ovary has a dual blood supply, so flow can persist despite torsion: a normal scan does not exclude it when the history fits.
Treatment Options
Treatment is surgical and urgent. There is no medical management for a twisted ovary.
Surgical
Emergency laparoscopic surgery
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Laparoscopic detorsion
The ovary untwisted through keyhole ports, restoring blood flow. The first choice in almost every case, whatever the ovary looks like.
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Cystectomy at the same operation
Removing the cyst that caused the torsion, so it cannot recur. Sometimes deferred if the ovary is too swollen to operate on safely.
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Oophoropexy
Fixing the ovary to reduce the risk of it twisting again. Considered after repeat torsion or where the ligaments are unusually long.
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Oophorectomy
Removing the ovary, reserved for cases where it is clearly necrotic beyond recovery or where malignancy is suspected.
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Open surgery
Where laparoscopy is not feasible: advanced pregnancy, a very large mass, or extensive previous adhesions.
Post-operative
After the emergency
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Monitoring ovarian recovery
Ultrasound at six weeks and again at three months to confirm blood flow has returned and follicles are developing.
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Treating the underlying cyst
Where cystectomy was deferred because of swelling, removing the cyst as a planned second procedure.
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Ovarian reserve assessment
AMH testing where fertility is a concern, particularly if the opposite ovary has also been affected.
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Preventing recurrence
Removing dermoid and other persistent cysts, and considering oophoropexy where torsion has happened more than once.
Removing an ovary because it looks black at surgery was standard practice for decades and is now known to be wrong. Detorsion alone allows recovery in the large majority, even where the ovary appeared beyond saving.
The Emergency Detorsion Procedure
The operation takes thirty to ninety minutes and is done as soon as theatre can be arranged.
Urgent keyhole surgery under general anaesthesia
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Rapid preparation
Bloods, pregnancy test and consent taken quickly. Fasting is ideal but surgery is not delayed unduly for it where suspicion is high.
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Anaesthesia and access
General anaesthesia, with a camera port at the umbilicus and two small ports low on the abdomen.
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Confirming the diagnosis
The ovary is seen to be enlarged, congested and twisted around its pedicle, often dark purple or black.
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Untwisting the ovary
The pedicle is gently unwound. Blood flow frequently returns visibly over the following minutes as the tissue re-perfuses.
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Assessing viability
The ovary is observed for a period. Appearance is a poor guide to recovery, so it is conserved unless frankly necrotic.
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Removing the causative cyst
The cyst shelled out where the ovary is not too oedematous. Where it is, this is deferred to a planned second operation.
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Closure and recovery
Ports closed and the patient recovered on the ward. Most women go home within one to two days.
The old fear that untwisting the ovary would release a clot causing embolism has not been borne out by evidence. Detorsion is safe, and preserving the ovary is now the standard of care.
Why Choose Lux Hospitals for Ovarian Torsion?
In torsion, how quickly you reach theatre determines whether the ovary survives. Here is why patients trust us:
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Urgent assessment and same-day theatre
Suspected torsion assessed immediately and operated on without waiting for a clinic slot, because the window is measured in hours.
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The ovary conserved
Detorsion rather than removal wherever possible, since a black-looking ovary usually recovers and appearance is a poor guide.
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Comprehensive care
From the first consultation through to post-treatment follow-up, with one team throughout.
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Convenient location
Our hospital is in HITEC CITY, near IKEA: easily reachable from across Hyderabad.
Recovery & Aftercare
Physical recovery from keyhole surgery is quick. Whether the ovary recovers is answered over the following months.
- Days 1–2
Pain settles substantially once blood flow is restored. Mobilising the same evening, with discharge at one to two days.
- Days 3–14
Port-site soreness reduces. Most women return to desk work at one to two weeks.
- Weeks 2–6
Normal activity resumes. Intercourse after clearance at four weeks. Any histology from a removed cyst is reviewed.
- Week 6
Ultrasound to assess whether blood flow has returned to the ovary and whether follicles are developing normally.
- Months 3–6
Repeat scan confirming ovarian recovery. In the large majority the ovary resumes normal function.
Aftercare
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Attend the follow-up scans
Whether the ovary recovered is only answered on imaging at six weeks and three months. It is worth knowing rather than assuming.
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Treat any recurrence of pain as urgent
Torsion can happen again, on either side. Sudden severe one-sided pain after a previous torsion means going straight to hospital.
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Ask about fertility if it concerns you
One healthy ovary is generally sufficient for normal fertility. Where reserve is a worry, AMH testing gives a clearer picture.
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Avoid heavy lifting for four weeks
Nothing over five kilograms while the port sites heal. Walking is encouraged from the first day.
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Have the causative cyst dealt with
If cystectomy was deferred because of swelling, do not let the planned second procedure drift: the cyst is what caused the torsion.
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Mention it during fertility treatment
Ovarian stimulation substantially raises torsion risk. A previous torsion is important information for anyone planning IVF.
Most ovaries operated on promptly recover fully, even those that looked black at surgery. And a woman with one functioning ovary generally has entirely normal fertility, which is worth knowing if the worst happened.
When Should You Seek Emergency Care?
Go to hospital immediately if any of the following apply.
- Sudden severe pain on one side of the lower abdomen.
- Severe pelvic pain with nausea and vomiting.
- Pain that came on abruptly during exercise or movement.
- Severe one-sided pain with a known ovarian cyst.
- Repeated episodes of severe pain that come and go.
- Severe pelvic pain during pregnancy or fertility treatment.
Cost of Ovarian Torsion Treatment in Hyderabad
This is emergency surgery, so cost reflects urgent admission and out-of-hours theatre rather than a planned procedure.
| Procedure | Estimated Cost |
|---|---|
| Emergency consultation Urgent assessment | ₹1,000 – ₹2,500 |
| Urgent workup Bloods, pregnancy test, ultrasound with Doppler | ₹4,000 – ₹9,000 |
| Laparoscopic detorsion One to two nights | ₹1,20,000 – ₹2,10,000 |
| Detorsion with cystectomy Cyst removed at the same operation | ₹1,50,000 – ₹2,60,000 |
| Detorsion with oophoropexy Ovary fixed to prevent recurrence | ₹1,60,000 – ₹2,70,000 |
| Oophorectomy Where the ovary is not salvageable | ₹1,40,000 – ₹2,40,000 |
| Follow-up ultrasound At six weeks and three months | ₹1,500 – ₹3,500 |
What changes the estimate
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What is done at surgery
Simple detorsion is the least involved. Adding cystectomy or oophoropexy lengthens the operation and raises the cost.
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Out-of-hours emergency
Torsion does not wait for a convenient time. Emergency admission and theatre outside normal hours cost more than planned surgery.
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Pregnancy
Torsion in pregnancy requires additional monitoring and obstetric input, and may need an open approach.
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Room category
A shared ward, a twin-sharing room or a private suite: the largest single swing in most estimates.
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Insurance & TPA cover
We are empanelled with most major insurers, and our team files the pre-authorisation for you.
Every figure above is an indicative range, not a quote. After your consultation you are given a written, fixed-cost estimate, and that is the number you pay, with no additions once treatment begins.
Other Gynecology & Obstetrics Treatments
Our Surgeons
Ovarian Torsion Specialists at Lux Hospitals
The gynaecologists who treat ovarian torsion at our HITEC CITY hospital.
-
Dr. Harshita Kakarla
Consultant Gynaecologist & Advanced Laparoscopic Surgeon
MBBS, MS, FMAS
16 years experience
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Dr. Ashwani Narla
Consultant Obstetrician, Gynecologist & Laparoscopic Surgeon
MBBS, MS (Obstetrics & Gynaecology)
11 years experience
Testimonials
What Patients Say About Their Treatment
Reviews from women treated for gynaecological conditions at Lux Hospitals, Hyderabad.
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Got Questions?
Frequently Asked Questions
Common questions about ovarian torsion, emergency surgery and what treatment costs at Lux Hospitals.
Is ovarian torsion dangerous?
It is a genuine surgical emergency. Twisting cuts off the ovary’s blood supply, and without prompt surgery the ovary dies and is lost. Rarely, a necrotic ovary can lead to infection or peritonitis. The ovary is usually saveable if surgery happens within hours, which is why this cannot wait for an appointment.
What are the symptoms of ovarian torsion?
Sudden severe pain on one side of the lower abdomen, usually with nausea and vomiting, often starting abruptly during movement or exercise. Some women have a dull ache for days beforehand, or repeated episodes of severe pain that resolve, which suggests the ovary is twisting and untwisting.
How is ovarian torsion diagnosed?
Primarily clinically. Ultrasound with Doppler shows an enlarged swollen ovary, usually with a cyst, and may show reduced blood flow. Critically, normal Doppler flow does not exclude torsion, because the ovary has a dual blood supply. Where suspicion is high, laparoscopy is both the definitive diagnosis and the treatment.
What is the difference between ovarian torsion and cyst torsion?
They usually describe the same event. In the great majority of cases it is a cyst that makes the ovary heavy enough to twist, so the whole ovary and often the tube rotate together: properly called adnexal torsion. Torsion of a completely normal ovary does occur, mostly in children, but it is uncommon.
Can ovarian torsion affect fertility?
If the ovary is saved by prompt detorsion, it usually resumes normal function and fertility is unaffected. Even where an ovary is lost, one healthy ovary is generally sufficient for entirely normal fertility. The concern arises mainly if both ovaries have been affected on separate occasions.
Will my ovary be removed?
Usually not. Standard practice is now to untwist the ovary and conserve it, even when it looks black and lifeless: appearance at surgery is a poor guide, and the majority recover. Removal is reserved for an ovary that is frankly necrotic or where malignancy is suspected.
Can ovarian torsion happen again?
Yes, on either side, particularly if the underlying cyst was not removed or if the suspensory ligaments are unusually long. Removing the causative cyst substantially reduces the risk, and oophoropexy, fixing the ovary in position, is considered after repeat episodes.
Is ovarian torsion surgery safe?
Laparoscopic detorsion is a well-established emergency operation with a good safety record. The risks are those of any keyhole surgery (bleeding, infection, injury to adjacent structures) all uncommon. The far greater risk in torsion is delay, not the operation itself.
How much does ovarian torsion treatment cost in Hyderabad?
Laparoscopic detorsion at Lux Hospitals is ₹1,20,000–₹2,10,000, detorsion with cystectomy ₹1,50,000–₹2,60,000, and with oophoropexy ₹1,60,000–₹2,70,000. Urgent assessment and workup adds ₹5,000–₹11,500. Emergency out-of-hours surgery costs more than a planned procedure.
How can I be seen urgently at Lux Hospitals?
For suspected torsion, come straight to Lux Hospitals, HITEC CITY rather than booking an appointment: the window for saving the ovary is measured in hours. Calling ahead helps us prepare, but do not delay your journey to make the call.
Still have questions? Call us at 079 6908 4422
Still have questions? Message us on WhatsApp at 079 6908 4444
Suspected Ovarian Torsion? Come In Today
Sudden severe one-sided pelvic pain needs assessing the same day. Our gynaecologists operate urgently to save the ovary.
Plot No.116, Lumbini Avenue, HITEC CITY, Near IKEA, Hyderabad – 500032